Evidence of Zika virus circulation in asymptomatic pregnant women in Northeast, Brazil.

BACKGROUND: Zika virus (ZIKV) is a flavivirus associated with microcephaly and other fetal anormalities. However, evidence of asymptomatic ZIKV infection in pregnant women is still scarce. This study investigated the prevalence of Zika infection in asymptomatic pregnant women attending two public maternities in Maranhão state, Northeast Brazil. METHODS: A total of 196 women were recruited at the time of delivery by convenience sampling from two maternity clinics in São Luís, Maranhão, Brazil, between April 2017 and June 2018. Venous blood, umbilical cord blood and placental fragments from maternal and fetal sides were collected from each subject. ZIKV infection was determined by reverse transcription polymerase chain reaction (RT-qPCR) for ZIKV and by serology (IgM and IgG). Nonspecific laboratory profiles (TORCH screen) were obtained from medical records. RESULTS: The participants were mostly from São Luís and were of 19-35 years of age. They had 10-15 years of schooling and they were of mixed race, married, and Catholic. ZIKV was identified in three umbilical cord samples and in nine placental fragments. Mothers with positive ZIKV RT-qPCR were in the age group older than 19 years. Of the 196 women tested by ZIKV rapid test, 6 and 117 women were positive for anti-ZIKV IgM and anti-ZIKV IgG antibodies, respectively. Placental Immunohistochemistry study detected ZIKV in all samples positive by RT-PCR. The newborns did not show any morphological and/or psychomotor abnormalities at birth. CONCLUSIONS: Asymptomatic ZIKV infection is frequent, but it was not associated to morphological and/or psychomotor abnormalities in the newborns up to 6 months post-birth. Although pathological abnormalities were not observed at birth, we cannot rule out the long term impact of apparent asymptomatic congenital ZIKV infection.

Prevalence of human papillomavirus infection among women from quilombo communities in northeastern Brazil.

BACKGROUND: Human papillomavirus (HPV) is a member of the Papillomaviridae family. The prevalence of HPV genotypes may vary according to the region and the population studied. Quilombo communities are ethnic and racial groups with difficult access to health services compared to the general population in Brazil. The aim of this study was to identify specific HPV types correlating with sociodemographic/behavioral characteristics and cervical smear cytological abnormalities in Quilombola women. METHODS: This cross-sectional study included 395 Quilombola women users of the Unified Health System of the Municipalities of Maranhão for the screening of cervical cancer. The samples were analyzed for the presence of cytological abnormalities by conventional methods and tested for 37 HPV genotypes using polymerase chain reaction with primers PGMY09/11 followed by reverse line blot hybridization performed with the Linear Array HPV Genotyping Test kit by Roche Molecular System®. The association between HPV types and cytological diagnosis was investigated according to the different age groups. RESULTS: HPV infection was detected in 12.6% (50/395) of the women. Infections by high-risk HPV types were more frequent. Genotypes 68 (26.0%); 58 and 52 (20.0%); 31 (10.0%) and 62 (8.0%) were the most prevalent. The highest prevalence (42.0%) of HPV infection occurred in women diagnosed with high-grade squamous intraepithelial lesion. There was a statistically significant association between HPV infection and the detection of cytological abnormalities in all age groups except in women over 60 years. There was a statistically significant association between the municipality of origin and the number of partners with HPV infection. CONCLUSIONS: It is important to incorporate new cervical cancer screening techniques incorporating the cervical-vaginal cytology. For further studies, it is necessary to determine the level of knowledge of Quilombola population on health-related issues including HPV infection and cervical cancer. This will contribute to the continuous improvement of healthcare coverage among the population and enhance the implementation of cancer care in the state of Maranhão.

Burnout no trabalho de médicos pediatras / Pediatricians' job burnout

Contexto: A síndrome de esgotamento profissional ou burnout é uma reação de estresse excessivo relacionada ao trabalho, a qual se apresenta em três dimensões: exaustão emocional, despersonalização e reduzida realização profissional. Objetivos: O presente estudo teve como objetivo identificar e comparar essas três dimensões presentes nos pediatras do Hospital Universitário da Universidade Federal do Maranhão (UFMA) ­ Unidade Materno Infantil. Métodos: Trata-se de um estudo quantitativo e descritivo envolvendo 78 profissionais. Utilizou-se como instrumento de pesquisa o Maslach Burnout Inventory e o questionário sociodemográfico. Resultados: A análise dos dados apontou que a prevalência de burnout foi de 2,6%. Níveis elevados de exaustão emocional, despersonalização e reduzida realização profissional foram encontrados em 42,3, 38,5 e 6,4% dos entrevistados, respectivamente. A prevalência de nível elevado em duas dimensões foi de 23,1%. Conclusões: Os pediatras apresentaram altos valores de exaustão emocional e baixos valores de despersonalização e reduzida realização profissional. Ressalta-se a necessidade de estruturação de programas de enfrentamento de burnout a fim de evitar o adoecimento de profissionais envolvidos com a promoção da saúde de crianças e adolescentes.

Background: Burnout is an excessive work-related stress response that involves three main dimensions: emotional exhaustion, depersonalization and reduced professional achievement. Aims: The present study aimed to identify and compare these three dimensions among pediatricians at the Mother-Child Unit of University Hospital, Federal University of Maranhão (Universidade Federal do Maranhão ­ UFMA). Methods: The present quantitative and descriptive study included 78 professionals. The Maslach Burnout Inventory and a sociodemographic questionnaire were used for data collection. Results: Data analysis showed that the prevalence of burnout was 2.6%. High levels of emotional exhaustion, depersonalization and reduced professional achievement were found in 42.3%, 38.5% and 6.4% of the participants, respectively. The prevalence of high levels in two of these dimensions simultaneously was 23.1%. Conclusions: The analyzed pediatricians exhibited high levels of emotional exhaustion and low values of depersonalization and reduced personal accomplishment. The need to develop programs against burnout is emphasized to avoid the occurrence of illness among professionals involved in the promotion of child and adolescent health.